Volume 3, Issue 7, July – 2018 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
The Knowledge and Minangkabau Culture in
Forming Society's Stigma Toward People with Mental
Disorder
1
Hariet Rinancy, 2Dr.dr.Hafni Bachtiar, MPH, 3Ns.Netrida, M.Kep.Sp.Kep.J
Abstract:- The stigma against people with mental
disorders in Indonesia is still irresistible, as a result, they
are isolated, and this can worsen their mental disorders
suffering. A stigma is influenced by knowledge and local
cultural background. The purpose of this research was to
know the correlation of knowledge and culture of
Minangkabau with the stigma of Minangkabau society
toward people with mental disorders. This research used a
quantitative method with crossectional approach.
Multistage sampling was utilized to get 81 respondents.
The research conducted in Tanah Datar, Agam, and
Padang Pariaman districts. Meanwhile, the chi-square test
was used to analyze the data. As the result of the research,
there was a significant correlation between knowledge and
culture of Minangkabau with the stigma of the society
toward people with mental disorders with the p-value
<0,05. This research was expected to be used as input for
Health Services and Community Health Centre
(Puskesmas). The Community Mental Health Nursing
(CMHN) approach could improve understanding of the
public that mental disorders was the same as other
physical illnesses, nothing needed to be ashamed of, could
be cured if it handled quickly and precisely. Thus, the
stigma regarding people with mental disorders would
lessen or disappeared, and people with mental disorders
could get the right treatment so that the number of mental
disorders' occurrence and relapse would decrease.
Keywords:- Mental disorders, Stigma, knowledge,
Minangkabau culture.
I. INTRODUCTION
The stigma toward people with mental disorders
(PwMD) in Indonesia is still dynamic, as a result, the sufferers
will feel isolated which will worsen the mental disorders
(MDs) (Gilang Purnama, Desi Indra yani, 2016). The stigma
created by the community towards people with mental
disorders indirectly causes families or communities around the
sufferers are unwilling to provide proper treatment to their
families or mentally ill neighbors (Chan, 2014). This attitude
is caused by unawareness or misinterpretation of the family or
society regarding mental disorders (Sulistyorini, 2013). So it is
not surprising when the sufferers of mental disorders are
mishandled, they will do violent behavior or uncontrolled
action that disturb family, society, and environment.
Public understanding regarding the causes of mental
disorders is often associated with traditional and cultural
values and disinclined to be open to scientific explanations
(Kamil, Jannah, & Tahlil, 2017). Another study conducted by
Tesfaye et al (Mu, 2013) in southwest Ethiopia found that
IJISRT18JL342 www.ijisrt.com
rural communities are more easily influenced by the spreading
stigma in society than people in urban areas. Generally,
natives in West Sumatera Province are people with
Minangkabau culture. People with mental disorders in
Minangkabau often called "urang gilo" which means insane or
crazy person. The life motto of Minangkabau community
"iduik bajaso mati bapusako" (life by meritorious, die
inherited) and "sahino samalu" (equally contemptible, equally
ashamed) (Ibrahim, 2016), caused the Minangkabau society
judge that people with mental disorders to be worthless and
disgrace for the family and the tribe.
This research aims to observe the knowledge level of
Minangkabau society about mental disorders and
Minangkabau culture against the stigma in people with mental
disorders.
II. MATERIALS AND METHOD
This research was quantitative by using crossectional
approach. The population in this research was the entire
Minangkabau society that resided in West Sumatra. The
sample size was calculated by using the Lemeshow formula,
and there were 81 total samples with inclusive criteria:
Minangkabau society aged 20-60 years, willing to be
respondents, able to communicate properly, ever had contact
people with mental disorders, and exclusive criteria if the
respondent was not encountered in three visits.
Multistage sampling was used as the sampling technique
in this research which meant that the sampling process was
done through two stages or more within the cluster but the
sampling withdrawal on the element was not directly done. 3
areas for this research were Tanah Datar, Agam, and Padang
Pariaman districts. Based on the calculation of samples by
using Lemeshow formula above, hence obtained the
proportion of samples for each region, they were: Tanah Datar
district with 30 people in subdistrict Tanjung Emas
Kenagarian (M) Pagaruyuang Korong (M) Mandahiling,
Agam district with 23 people in subdistrict Lubuk Basung
Kenagarian (M) Lubuk Basung Korong (M) Koto Batu,
Padang Pariaman district with 28 people in subdistrict Batang
Gasan Kenagarian (M) Malai V Suku Korong (M) Kantarok.
Data collection technique was questionnaire of knowledge
level that consisted of 10 questions, cultural questionnaire
with 8 questions and stigma with 8 questions, and previously,
the validity and reliability tests had been conducted to the
three questionnaires. Informed consent was attached to the
questionnaire as a legal aspect of ethics that stated the
willingness to be a respondent. Data analysis used Chi-Square
technique with confident interval 95% and α = 0,005.
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III. RESULT AND DISCUSSION
A. Result
The results showed that majority of respondents (63%)
had inadequate knowledge about mental disorders and 37%
had sufficient knowledge which could be seen in table.1. Most
respondents (67,9%) indicated that Minangkabau culture did
not support health and 32.1% supported the health as seen in
table.2. 60.5% of respondents had heavy stigmatization
against people with mental disorders and 39.5% of
respondents had light stigmatization which can be seen in
table.3.
Respondents with inadequate knowledge about mental
disorders heavy stigmatized people with mental disorders by
94,1%. From the result of the statistical test with chi-square
got p-value = 0.000 < from the degree of significance 0,05
which meant that there was a significant relationship between
the level of knowledge and the stigma of Minangkabau society
as could be seen in table.4. The cultural aspect that did not
support the health regarding people with mental disorders had
heavy stigmatization by 85,5% and those with light stigma by
14,5%. From the result of the statistical test found that there
was a meaningful relationship between the culture and the
stigma of Minangkabau which could be seen in table.5.
B. Discussion
The results of the research found that most of the
Minangkabau society had heavy stigmatization toward people
with mental disorders. Supported by the results of the research
by (Neupane, Dhakal, Thapa, & Bhandari, 2016) states that
the caregivers stigmatize the patients heavily with median
scores (12-60). Likewise, the results of Suryani's research
(2013) which states that the stigma against people with mental
disorders in Indonesia is still severe.
More than half of Minangkabau societies with
inadequate knowledge have heavy stigmatization toward
PwMD. Relevant to the results of the research by (Teresha,
Tyaswati, & Widhiarta, 2015) state that (71%) students with
high knowledge about mental disorders have a higher positive
attitude towards MDs patients. The research results of (Mu,
2013) in Southwest Ethiopia also infer that the lower the level
of society's knowledge about mental disorders, the more
severe the stigma toward PwMD. According to Notoatmodjo
in (Wawan.A, 2011) that the knowledge regarding disease and
illness include: causes, symptoms, way of treatment, method
of transmission, and prevention are the very important
domains for the formation of an overt behavior.
So it is necessary to increase the knowledge of
Minangkabau society about mental disorders so that the
society will know and understand the causes of mental
disorders, the way of medicating, and treating them. In
addition, the society will realize that mental illness is the same
as any other physical illness, so the heavy stigmatization
toward people with mental disorders becomes lighter or even
ignored. This can be realized by granting health education
regarding mental disorders with Community Mental Health
Nursing (CMHN) approach.
IJISRT18JL342 www.ijisrt.com
International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Culture is very influential on the behavior and
perceptions of a person against individuals with mental health.
Understanding of cultures that related to stigma greatly affects
a person with mental health. Based on the result of the
research, there was a significant correlation between the
culture with the stigma of Minangkabau society to people with
mental disorders, where more than half (85,5%) of the society
had heavy stigmatization toward PwMD with a level of
significance (P = 0.000). This is in accordance with the results
of a research by (Suciati & Agung, 2010) which state that
culture affects a person in the expression and attitude towards
an object. Where there are significant differences between
Batak culture, Minangkabau, and Javanese in expression,
emotion, and attitude towards an object as well as the response
to PwMD.
According to the results of the questionnaire distributed
in Minangkabau, only a small percentage (38.3%) of the
community claimed that mental disorders were caused by
witchcraft or possession of spirits. The heavy stigmatization
that is given by the Minangkabau community towards PwMD
closely related to the Minangkabau society's motto “sahino
samalu”. The meaning of this motto is the sense of humiliation
and shame that is felt by a person is also a sense of disgrace
and dishonor for the whole family and clan. Most of the
societies (91,4%) will feel humiliated if a member of their clan
have a mental disorders, and more than half of the
communities (67.7%) assume that PwMD is incompetent and
unproductive in accordance with the motto of the
Minangkabau society “iduik bajaso mati bapusako”. It means
that according to Minangkabau culture, the essence of life is
good and always give the virtue, can be productive to give
something beneficial for family and clan, even after the death
can leave worthwhile inheritances. (Miko, 2017).
The high percentage of Minangkabau culture that does
not support health is due to the inadequate of perception and
knowledge about mental disorders. The motto of the society
“sahino samalu” and “iduik bajaso mati bapusako” is actually
excellent if the society understands that mental illness is the
same as any other physical disease. If it is given prompt and
proper treatment, the mental disorders can also be cured.
Similarly, heart disease, DMs, and other degenerative diseases
are also caused by genetic factors. If the society understands
and knows about the mental disorders correctly, then the
stigmatization can be decreased and even be obliterated.
In accordance with the Leininger's acknowledgement, it
is crucial to pay attention to the culture of the society in
performing nursing actions, where there are some cultures that
support health so that the cultures are worth to support and
there are also some cultures that do not support health so they
need to be changed or restructured. Well, Minangkabau
culture that regulates the social life which is conveyed in the
mottos "sahino samalu" and "Iduik bajaso mati bapusako" is
not wrong, but need to be restructured by increasing the
knowledge and understanding of society about mental
disorders. Therefore, there is no more disgrace and
counterproductive assumption against people with mental
disorders.
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Volume 3, Issue 7, July – 2018 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
IV. CONCLUSION ethnic of Batak , Jawa , Melayu and Minangkabau, 99–
108.
Stigma is influenced by local knowledge, environment, [9]. Sulistyorini, N. (2013). GANGGUAN JIWA DI
and culture. The majority of societies in West Sumatera WILAYAH KERJA NASKAH PUBLIKASI Diajukan
Province cultured Minangkabau. Patients with mental Untuk Memenuhi Salah Satu Syarat Mencapai Derajat
disorders in Minangkabau often called "urang gilo" which Sarjana Keperawatan Disusun Oleh:, 1.
meant insane or crazy person. The motto of Minangkabau [10]. Teresha, D. A., Tyaswati, J. E., & Widhiarta, K. D.
society "iduik bajaso mati bapusako" and "sahino samalu" (2015). Perbedaan Pengetahuan , Stigma dan Sikap antara
made Minangkabau society judges that people with mental Mahasiswa Tingkat Awal dan Tingkat Akhir di Fakultas
disorders to be worthless and disgrace for the family and the Kedokteran Universitas Jember terhadap Gangguan Jiwa
tribe. Consequently, the society had heavy stigmatization The Difference of the Knowledge , Stigma and Attitude
toward people with mental disorders. In contrast to the culture between The First Year and Final Year Student of
in other places such as Yogyakarta, Medan, Euthopia, and Medical Faculty of Jember University toward Mental
Nigeria who believe that the cause of mental disorders was a Disorders, 1(2), 7–11.
curse and mystical things that made the society had a heavy [11]. Wawan.A. (2011). Teori dan Pengukuran
stigmatization against people with mental disorders. Pengetahuan, Sikap dan Perilaku Manusia. Yogyakarta:
Nuha Meddika.
V. SUGGESTION
LIST OF TABLES
It is expected that the local health service and
Community Health Centre (Ind Puskesmas) able to improve Table 1.The frequency distribution of Minangkabau society's
the promotion effort, preventive, curative, rehabilitative and knowledge level about mental disorders year 2018
active efforts to approach families who have members with
mental disorders. In addition, to provide CMHN training for Knowledge F %
nurses who have psychiatric programs at Puskesmas. So that Inadequate 51 63
society's knowledge about mental disorders will increase and Adequate 30 37
the stigma of Minangkabau society toward people with mental Total 81 100
disorders will decrease or even disappear.
Table 2.The frequency distribution of Minangkabau society's
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Total 81 100
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Keluarga terhadap Penderita Skizofrenia Ditinjau dari Stigma F %
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[5]. Miko, A. (2017). Sosiologi Lansia Pergeseran Pranata Total 81 100
Penyantunan Lansia Dalam Keluraga Minangkabau yang
Berubah di Sumatera Barat. (Bustin, Ed.). Bukittinggi: Table 4 The relation of knowledge level with Minangkabau
Erka. society’s stigma toward people with mental disorders Year
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(2016). Caregivers ’ Attitude towards People with Mental Total %
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Volume 3, Issue 7, July – 2018 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Table 5 The relation of culture with Minangkabau society’s
stigma toward people with mental disorders Year 2018

Culture Society’s Stigma P

Light Heavy
Total %
f % f %
Does not 8 14,5 47 85,5 0,000
support the 55 100
health
Support the 24 92,3 2 7,7
health 26 100

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